CDE Detailed Report

Disease: Sport-Related Concussion
Subdomain Name: Quality of Life/Patient Reported Outcomes
CRF: Neuro-QOL Adult Bank - Cognitive Function

Displaying 1 - 28 of 28
CDE ID CDE Name Variable Name Definition Short Description Question Text Permissible Values Description Data Type Disease Specific Instructions Disease Specific Reference Population Classification (e.g., Core) Version Number Version Date CRF Name (CRF Module / Guidance) Subdomain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
C21198 Quality of Life - Keep track time difficulty scale QoLKeepTrackTimeDifficultyScl The scale which represents the amount of difficulty the participant currently has in keeping track of time (e.g., using a clock), as part of Neuro-QOL Cognitive Function The scale which represents the amount of difficulty the participant currently has in keeping track of time (e.g., using a clock), as part of Neuro-QOL Cognitive Functio How much DIFFICULTY do you currently have keeping track of time (eg., using a clock)? 5;4;3;2;1 None;A little;Somewhat;A lot;Cannot do Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
C21209 Quality of Life - Almost remember word past week scale QoLAlmostRememberWordScl The scale representing how often words the participant wanted to use seemed to be on the "tip of their tongue" in the past 7 days, as part of Neuro-QOL Cognitive Function The scale representing how often words the participant wanted to use seemed to be on the "tip of their tongue" in the past 7 days, as part of Neuro-QOL Cognitive Functio In the past 7 days words I wanted to use seemed to be on the "tip of my tongue" 5;4;3;2;1 Never;Rarely (once);Sometimes (2-3 times);Often (once a day);Very often (several times a day) Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
C21220 Quality of Life - Thought process slow past week scale QoLThoughtProcessSlowScl The scale representing how often the participant's thinking was slow in the past 7 days, as part of Neuro-QOL Cognitive Function The scale representing how often the participant's thinking was slow in the past 7 days, as part of Neuro-QOL Cognitive Functio In the past 7 days my thinking was slow 5;4;3;2;1 Never;Rarely (once);Sometimes (2-3 times);Often (once a day);Very often (several times a day) Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
C21199 Quality of Life - Check financial document accuracy difficulty scale QoLCheckFinanclDocAccurcyScl The scale which represents the amount of difficulty the participant currently has in checking the accuracy of financial documents (e.g., bills, checkbook, or bank statements), as part of Neuro-QOL Cognitive Function The scale which represents the amount of difficulty the participant currently has in checking the accuracy of financial documents (e.g., bills, checkbook, or bank statements), as part of Neuro-QOL Cognitive Functio How much DIFFICULTY do you currently have checking the accuracy of financial documents, (e.g., bills, checkbook, or bank statements)? 5;4;3;2;1 None;A little;Somewhat;A lot;Cannot do Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
C21210 Quality of Life - Several repeat read past week scale QoLSeveralRptReadScl The scale representing how often the participant had to read something serveral times to understand it in the past 7 days, as part of Neuro-QOL Cognitive Function The scale representing how often the participant had to read something serveral times to understand it in the past 7 days, as part of Neuro-QOL Cognitive Functio In the past 7 days I had to read something several times to understand it 5;4;3;2;1 Never;Rarely (once);Sometimes (2-3 times);Often (once a day);Very often (several times a day) Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
C21221 Quality of Life - Attention difficulty past week scale QoLAttentionDifficultyScl The scale representing how often the participant had to work really hard to pay attention or they would make a mistake in the past 7 days, as part of Neuro-QOL Cognitive Function The scale representing how often the participant had to work really hard to pay attention or they would make a mistake in the past 7 days, as part of Neuro-QOL Cognitive Functio In the past 7 days I had to work really hard to pay attention or I would make a mistake 5;4;3;2;1 Never;Rarely (once);Sometimes (2-3 times);Often (once a day);Very often (several times a day) Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
C21200 Quality of Life - Read follow complex instruction difficulty scale QoLReadComplexInstrDifficltScl The scale which represents the amount of difficulty the participant currently has in reading and following complex instructions (e.g., directions for a new medication), as part of Neuro-QOL Cognitive Function The scale which represents the amount of difficulty the participant currently has in reading and following complex instructions (e.g., directions for a new medication), as part of Neuro-QOL Cognitive Functio How much DIFFICULTY do you currently have reading and following complex instructions (e.g., directions for a new medication)? 5;4;3;2;1 None;A little;Somewhat;A lot;Cannot do Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
C21211 Quality of Life - Trouble keep track interrupt past week scale QoLTrbleKeepTrackInteruptScl The scale representing how often the participant had trouble keeping track of what they were doing if they were interrupted in the past 7 days, as part of Neuro-QOL Cognitive Function The scale representing how often the participant had trouble keeping track of what they were doing if they were interrupted in the past 7 days, as part of Neuro-QOL Cognitive Functio In the past 7 days I had trouble keeping track of what I was doing if I was interrupted 5;4;3;2;1 Never;Rarely (once);Sometimes (2-3 times);Often (once a day);Very often (several times a day) Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
C21222 Quality of Life - Trouble concentrate past week scale QoLTroubleConcentrateScl The scale representing how often the participant had trouble concentrating in the past 7 days, as part of Neuro-QOL Cognitive Function The scale representing how often the participant had trouble concentrating in the past 7 days, as part of Neuro-QOL Cognitive Functio In the past 7 days I had trouble concentrating 5;4;3;2;1 Never;Rarely (once);Sometimes (2-3 times);Often (once a day);Very often (several times a day) Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
C21201 Quality of Life - Plan keep appointment not weekly routine difficulty scale QoLPlanKeepAppmntNtWklyRtneScl The scale which represents the amount of difficulty the participant currently has in planning for and keeping appointments that are not part of their weekly routine (e.g., a therapy or doctor appointment, or a social gathering with friends and family), as part of Neuro-QOL Cognitive Function The scale which represents the amount of difficulty the participant currently has in planning for and keeping appointments that are not part of their weekly routine (e.g., a therapy or doctor appointment, or a social gathering with friends and family), as part of Neuro-QOL Cognitive Functio How much DIFFICULTY do you currently have planning for and keeping appointments that are not part of your weekly routine, (e.g., a therapy or doctor appointment, or a social gathering with friends and family)? 5;4;3;2;1 None;A little;Somewhat;A lot;Cannot do Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
C21212 Quality of Life - Multitask difficulty past week scale QoLMultitaskDifficultyScl The scale representing how often the participant had difficulty doing more than one thing at a time in the past 7 days, as part of Neuro-QOL Cognitive Function The scale representing how often the participant had difficulty doing more than one thing at a time in the past 7 days, as part of Neuro-QOL Cognitive Functio In the past 7 days I had difficulty doing more than one thing at a time 5;4;3;2;1 Never;Rarely (once);Sometimes (2-3 times);Often (once a day);Very often (several times a day) Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
C21223 Quality of Life - Trouble start simple task past week scale QoLTroubleStartSimpleTaskScl The scale representing how often the participant had trouble getting started on very simple tasks in the past 7 days, as part of Neuro-QOL Cognitive Function The scale representing how often the participant had trouble getting started on very simple tasks in the past 7 days, as part of Neuro-QOL Cognitive Functio In the past 7 days I had trouble getting started on very simple tasks 5;4;3;2;1 Never;Rarely (once);Sometimes (2-3 times);Often (once a day);Very often (several times a day) Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
C21202 Quality of Life - Manage time daily activity difficulty scale QoLManagTmeDlyActvityDiffScl The scale which represents the amount of difficulty the participant currently has in managing their time to do most of their daily activities, as part of Neuro-QOL Cognitive Function The scale which represents the amount of difficulty the participant currently has in managing their time to do most of their daily activities, as part of Neuro-QOL Cognitive Functio How much DIFFICULTY do you currently have managing your time to do most of your daily activities? 5;4;3;2;1 None;A little;Somewhat;A lot;Cannot do Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
C21213 Quality of Life - Task memory trouble past week scale QoLTaskMemoryTroubleScl The scale representing how often the participant had trouble remembering whether they did things they were supposed to do, like taking a medicine or buying something they needed, in the past 7 days, as part of Neuro-QOL Cognitive Function The scale representing how often the participant had trouble remembering whether they did things they were supposed to do, like taking a medicine or buying something they needed, in the past 7 days, as part of Neuro-QOL Cognitive Functio In the past 7 days I had trouble remembering whether I did things I was supposed to do, like taking a medicine or buying something I needed 5;4;3;2;1 Never;Rarely (once);Sometimes (2-3 times);Often (once a day);Very often (several times a day) Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
C21224 Quality of Life - Trouble make decision past week scale QoLTroubleMakeDecisionScl The scale representing how often the participant had trouble making decisions in the past 7 days, as part of Neuro-QOL Cognitive Function The scale representing how often the participant had trouble making decisions in the past 7 days, as part of Neuro-QOL Cognitive Functio In the past 7 days I had trouble making decisions 5;4;3;2;1 Never;Rarely (once);Sometimes (2-3 times);Often (once a day);Very often (several times a day) Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
C21203 Quality of Life - Plan activity ahead time difficulty scale QoLPlanActvityAheadTimeDiffScl The scale which represents the amount of difficulty the participant currently has in planning an activity several days in advance (e.g., a meal, trip, or visit to friends), as part of Neuro-QOL Cognitive Function The scale which represents the amount of difficulty the participant currently has in planning an activity several days in advance (e.g., a meal, trip, or visit to friends), as part of Neuro-QOL Cognitive Functio How much DIFFICULTY do you currently have planning an activity several days in advance (e.g., a meal, trip, or visit to friends)? 5;4;3;2;1 None;A little;Somewhat;A lot;Cannot do Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
C21214 Quality of Life - Trouble remembering new information past week scale QoLTrbleRememberingNewInfoScl The scale representing how often the participant had trouble remembering new information, like phone numbers of simple instructions, in the past 7 days, as part of Neuro-QOL Cognitive Function The scale representing how often the participant had trouble remembering new information, like phone numbers of simple instructions, in the past 7 days, as part of Neuro-QOL Cognitive Functio In the past 7 days I had trouble remembering new information, like phone numbers or simple instructions 5;4;3;2;1 Never;Rarely (once);Sometimes (2-3 times);Often (once a day);Very often (several times a day) Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
C21225 Quality of Life - Trouble plan task step past week scale QoLTroublePlanTaskStepScl The scale representing how often the participant had trouble planning out steps of a task in the past 7 days, as part of Neuro-QOL Cognitive Function The scale representing how often the participant had trouble planning out steps of a task in the past 7 days, as part of Neuro-QOL Cognitive Functio In the past 7 days I had trouble planning out steps of a task 5;4;3;2;1 Never;Rarely (once);Sometimes (2-3 times);Often (once a day);Very often (several times a day) Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
C21204 Quality of Life - Organize difficulty scale QoLOrganizeDiffScl The scale which represents the amount of difficulty the participant currently has in getting things organized, as part of Neuro-QOL Cognitive Function The scale which represents the amount of difficulty the participant currently has in getting things organized, as part of Neuro-QOL Cognitive Functio How much DIFFICULTY do you currently have getting things organized? 5;4;3;2;1 None;A little;Somewhat;A lot;Cannot do Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
C21215 Quality of Life - Room Walked into room and forgot why past week scale QoLWalkedIntoRoomForgotWhyScl The scale representing how often the participant walked into a room and forgot what they meant to do or get there in the past 7 days, as part of Neuro-QOL Cognitive Function The scale representing how often the participant walked into a room and forgot what they meant to do or get there in the past 7 days, as part of Neuro-QOL Cognitive Functio In the past 7 days I walked into a room and forgot what I meant to do or get there 5;4;3;2;1 Never;Rarely (once);Sometimes (2-3 times);Often (once a day);Very often (several times a day) Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
C21205 Quality of Life - Remember object location difficulty scale QoLRemembrObjctLocationDiffScl The scale which represents the amount of difficulty the participant currently has in remembering where things were placed or put away (e.g., keys), as part of Neuro-QOL Cognitive Function The scale which represents the amount of difficulty the participant currently has in remembering where things were placed or put away (e.g., keys), as part of Neuro-QOL Cognitive Functio How much DIFFICULTY do you currently have remembering where things were placed or put away (e.g., keys)? 5;4;3;2;1 None;A little;Somewhat;A lot;Cannot do Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
C21216 Quality of Life - Familiar person name remember difficulty past week scale QoLFamiliarNameRememberDiffScl The scale representing how often the participant had trouble remembering the name of a familiar person in the past 7 days, as part of Neuro-QOL Cognitive Function The scale representing how often the participant had trouble remembering the name of a familiar person in the past 7 days, as part of Neuro-QOL Cognitive Functio In the past 7 days I had trouble remembering the name of a familiar person 5;4;3;2;1 Never;Rarely (once);Sometimes (2-3 times);Often (once a day);Very often (several times a day) Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
C21206 Quality of Life - Remember errand not written difficulty scale QoLRemembrErrndNotWrttnDiffScl The scale which represents the amount of difficulty the participant currently has in remembering a list of 4 to 5 errands without writing it down, as part of Neuro-QOL Cognitive Function The scale which represents the amount of difficulty the participant currently has in remembering a list of 4 to 5 errands without writing it down, as part of Neuro-QOL Cognitive Functio How much DIFFICULTY do you currently have remembering a list of 4 to 5 errands without writing it down? 5;4;3;2;1 None;A little;Somewhat;A lot;Cannot do Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
C21217 Quality of Life - Clear thought difficulty past week scale QoLClearThoughtDifficultyScl The scale representing how often the participant had trouble thinking clearly in the past 7 days, as part of Neuro-QOL Cognitive Function The scale representing how often the participant had trouble thinking clearly in the past 7 days, as part of Neuro-QOL Cognitive Functio In the past 7 days I had trouble thinking clearly 5;4;3;2;1 Never;Rarely (once);Sometimes (2-3 times);Often (once a day);Very often (several times a day) Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
C21207 Quality of Life - Learn new task difficulty scale QoLLearnNewTaskDiffScl The scale which represents the amount of difficulty the participant currently has in learning new tasks or instructions, as part of Neuro-QOL Cognitive Function The scale which represents the amount of difficulty the participant currently has in learning new tasks or instructions, as part of Neuro-QOL Cognitive Functio How much DIFFICULTY do you currently have learning new tasks or instructions? 5;4;3;2;1 None;A little;Somewhat;A lot;Cannot do Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
C21218 Quality of Life - Reaction slow past week scale QoLReactionSlowScl The scale representing how often the participant reacted slowly to things that were said and done in the past 7 days, as part of Neuro-QOL Cognitive Function The scale representing how often the participant reacted slowly to things that were said and done in the past 7 days, as part of Neuro-QOL Cognitive Functio In the past 7 days I reacted slowly to things that were said and done 5;4;3;2;1 Never;Rarely (once);Sometimes (2-3 times);Often (once a day);Very often (several times a day) Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
C21208 Quality of Life - Simple mistake more easily past week scale QoLSimpleMistakeMoreEasilyScl The scale representing how often the participant made simple mistakes more easily in the past 7 days, as part of Neuro-QOL Cognitive Function The scale representing how often the participant made simple mistakes more easily in the past 7 days, as part of Neuro-QOL Cognitive Functio In the past 7 days I made simple mistakes more easily 5;4;3;2;1 Never;Rarely (once);Sometimes (2-3 times);Often (once a day);Very often (several times a day) Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
C21219 Quality of Life - Thought formation trouble past week scale QoLThoughtFormationTroubleScl The scale representing how often the participant had trouble forming thoughts in the past 7 days, as part of Neuro-QOL Cognitive Function The scale representing how often the participant had trouble forming thoughts in the past 7 days, as part of Neuro-QOL Cognitive Functio In the past 7 days I had trouble forming thoughts 5;4;3;2;1 Never;Rarely (once);Sometimes (2-3 times);Often (once a day);Very often (several times a day) Numeric Values

Part of Neuro-QOL Adult Bank - Cognitive Function

 Adult;Pediatric Supplemental 1.00 2015-07-15 16:11:38.0 Neuro-QOL Adult Bank - Cognitive Function Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected
CSV